Granted, Undecided, Withdrawn, and Refused Requests for Euthanasia and Physician-Assisted Suicide

Weide, Marijke C. Jansen-van der; Onwuteaka‐Philipsen, Bregje D.; Wal, Gerrit van der

doi:10.1001/archinte.165.15.1698

Cited by 111 publications

(93 citation statements)

References 22 publications

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“…In both countries explicit requests for euthanasia were not necessarily honoured. In our study as well as in other Dutch studies the most frequent reasons given for this discrepancy were that the patient withdrew the request or died before the request was granted [21]. However, in our study we observed that in some cases the physician in whose setting the patient died was not aware of a wish, let alone a request because these were expressed to another treating physician.…”

Section: Discussioncontrasting

confidence: 42%

Expressed wishes and incidence of euthanasia in advanced lung cancer patients

Pardon¹,

Deschepper²,

Stichele

et al. 2012

Eur Respir J

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This study explores expressed wishes and requests for euthanasia (i.e. administration of lethal drugs at the explicit request of the patient), and incidence of end-of-life decisions with possible life-shortening effects (ELDs) in advanced lung cancer patients in Flanders, Belgium.We performed a prospective, longitudinal, observational study of a consecutive sample of advanced lung cancer patients and selected those who died within 18 months of diagnosis. Immediately after death, the pulmonologist/oncologist and general practitioner (GP) of the patient filled in a questionnaire. Information was available for 105 out of 115 deaths.According to the specialist or GP, one in five patients had expressed a wish for euthanasia; and three in four of these had made an explicit and repeated request. One in two of these received euthanasia. Of the patients who had expressed a wish for euthanasia but had not made an explicit and repeated request, none received euthanasia. Patients with a palliative treatment goal at inclusion were more likely to receive euthanasia. Death was preceded by an ELD in 62.9% of patients.To conclude, advanced lung cancer patients who expressed a euthanasia wish were often determined. Euthanasia was performed significantly more among patients whose treatment goal after diagnosis was exclusively palliative.

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Section: Discussioncontrasting

confidence: 42%

Expressed wishes and incidence of euthanasia in advanced lung cancer patients

Pardon¹,

Deschepper²,

Stichele

et al. 2012

Eur Respir J

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“…Therefore, SCEN physicians see the more complex medical situations, and in accordance with the study performed by Pasman and colleagues, 19 it seems that physicians focus more on physical suffering. However, as loss of dignity is one of the most frequently mentioned reasons for requesting euthanasia or physician-assisted suicide, 2,6 it is important that SCEN physicians not only focus on physical symptoms but also pay attention to social, existential, and psychological factors that may influence the sense of dignity.…”

Section: Discussionmentioning

confidence: 99%

“…This is probably due to the fact that empirical research has shown that loss of dignity is an important concern for patients at the end of life. [1][2][3] Dignity is important to 92% of the Dutch general public when asked what they consider as important in their dying phase. 4 In addition, loss of dignity is one of the most common reasons to formulate an advance directive 5 and one of the most frequently mentioned reasons for requesting euthanasia or physician-assisted suicide in the Netherlands.…”

Section: Introductionmentioning

confidence: 99%

“…4 In addition, loss of dignity is one of the most common reasons to formulate an advance directive 5 and one of the most frequently mentioned reasons for requesting euthanasia or physician-assisted suicide in the Netherlands. 2,6 Maintaining dignity has been considered one of the main goals of palliative care. [7][8][9][10] A variety of studies identified factors and themes that may have an impact on the sense of dignity at the end of life.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Personal Dignity in the Terminally Ill from the Perspective of Caregivers: A Survey among Trained Volunteers and Physicians

Albers

Vet

Pasman

et al. 2013

Journal of Palliative Medicine

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Background: Although dignity is increasingly considered a goal of palliative care, little research has evaluated the understanding of dignity at the end of life from a caregiver's perspective. Objective: The study objective was to investigate and compare the views of trained volunteers and SCEN physicians on maintaining dignity for patients reaching the end of life. Design: The study is a survey questionnaire study. Subjects: Subjects were two groups of caregivers involved in care for dying patients: trained volunteers (n = 236) and end-of-life consultants (SCEN physicians; n = 427). Measurements: Measurement was done via the Dutch version of the 22-item Patient Dignity Inventory on symptoms and experiences that have been shown to influence the sense of dignity in terminally ill patients. Respondents were asked to rate on a five-point scale the extent to which they considered the items as influential on dignity in terminally ill patients, and as problematic in practice in maintaining dignity for patients in the last phase of life. Results: Overall, volunteers indicated items more frequently as influential to dignity and as problematic in maintaining dignity at the end of life, compared to SCEN physicians. Volunteers gave significantly higher ratings than SCEN physicians to most of the social items, and to half of the psychological and existential items. Conclusions: It seems that SCEN physicians consider the physical aspects of suffering to be most influential and problematic in practice in preserving dignity, while volunteers think psychosocial aspects are most important in preserving dignity at the end of life. These findings suggest that the role and responsibilities of caregivers involved in care for terminally ill patients affect the factors that they think influence dignity.

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“…2,3 It is known that most requests for euthanasia do not result in their actual completion, because either the patient dies naturally, or the physician considers the request not eligible, or a request is withdrawn. 4,5 It is noteworthy that, in particular, patients with depressive symptoms and (fear of) pain may change their mind over time. 2 In 2002, euthanasia and physician-assisted suicide were legalised in the Netherlands by the passing of the Euthanasia Act.…”

Section: Introductionmentioning

confidence: 99%